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• W1582045227 abstract "During the past decades, the worldwide spread of the human immuno-deficiency virus (HIV) has created one of the deadliest epidemics in history. In 2006, a total of 39.5 million people were living with HIV. Sub-Saharan Africa is clearly the most affected area of the world with more than 24 million people estimated to be infected with HIV in 2006 (UNAIDS & WHO 2007). Being home to merely 10 percent of the global population, sub-Saharan Africa is thus home to more than 60 percent of the HIV-positive people in the world. The international donor community’s policy response to the disease has been unprecedented. In the last decade, international and domestic funding for AIDS has increased from millions to billions, and by the end of 2007, AIDS funding reached nearly $10 billion. This represents an almost forty-fold increase since 1996 when the figure was $260 million (UNAIDS 2009). Much of the increase can be ascribed to a series of new funding initiatives and mechanisms such as UNAIDS, the Global Fund for AIDS, tuberculosis and malaria, the World Bank’s Global AIDS Programme and the US President's Emergency Plan for AIDS Relief (PEPFAR). Domestic spending has also increased and now represents about one third of all the money going into the global AIDS response (UNAIDS 2009). Yet, despite all these resources, the disease continues to spread, and especially in sub-Saharan Africa. This article aims at increasing our understanding about why the money does not seem to work for the people that need it most. As such, the article asks: Why is it that people in sub-Saharan Africa continue to die from HIV/AIDS despite all the resources allocated to preventing the further spread of the disease? In this article, we argue that there is a need to reassess the problem of HIV/AIDS and that one potential explanation to why the international donor community’s response to HIV/AIDS is partly ineffective is that it is based on a mischaracterization of the problem. More specifically, we argue that many assumptions that drive current HIV prevention strategies are unsupported by rigorous scientific evidence, and that AIDS programmes are as a consequence not adequately designed. For a start, the actors involved in HIV prevention lack a deeper understanding of the high costs and sacrifices involved in sexual behavior change. In addition, they have dismissed the fact that the HIV epidemic in sub-Saharan Africa is generalized and pre-dominantly heterosexual and as such requires other solutions than HIV epidemics in countries where transmissions are concentrated among sex workers, men who have sex with men, and injecting drug users. Moreover, the causes to HIV have in many instances been misunderstood. While poverty, structural and gender inequalities, and the sexual behavior of so called high-risk groups do certainly increase the magnitude of the problem, the vulnerability to HIV infection does not ultimately depend on these factors. In the remainder of this article, we further develop the argument that one potential reason to why HIV continues to spread in sub-Saharan Africa despite extensive resources is that the actors involved are to a considerable extent misinformed as regards what kind of problem HIV is. In the first section, we critically survey the status of current research and ask what the research community has to say when it comes to the question of what kind of problem HIV/AIDS is and how it can best be combated. In the second part of the article, we then explore how international donors define and characterize the problem of HIV/AIDS. In order to be able to assess the extent to which HIV prevention strategies are in fact supported by rigorous scientific evidence, we will analyze policy documents of the largest donors involved in HIV prevention, i.e. UNAIDS, Global Fund for AIDS, tuberculosis and malaria, the World Bank’s Global AIDS Programme and the US President's Emergency Plan for AIDS Relief (PEPFAR). Given that current research provides an accurate characterization of the problem, the larger the mismatch between this characterization and the characterization given by the international donor community the more important it might be for international donors to reassess their policy on HIV/AIDS." @default.
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• W1582045227 date "2009-01-01" @default.
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• W1582045227 title "Reviewing and Reassessing the Problem of HIV/AIDS" @default.
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